POS0044-HPR FEASIBILITY OF FITNESS ASSESSMENTS IN GROUP EXERCISE THERAPY FOR INDIVIDUALS WITH AXIAL SPONDYLOARTHRITIS
Authors: A. K. Rausch Osthoff, C. Horvath, K. Niedermann
Journal: Annals of the Rheumatic Diseases (2022)

Background Assessments should be standard in individual as well as group physical therapy. The Ankylosing Spondylitis Association of Switzerland has translated the EULAR recommendations for physical activity (PA) in a concept for group exercise therapy, which, in addition to guidance on exercising in all four fitness dimensions (aerobic, strength, flexibility, neuromotor function), also includes PA counselling and regular fitness assessments for the planning and documentation of the individual therapy progress as well for quality monitoring of the exercise groups. Objectives To evaluate the feasibility of the selected assessments across all four fitness dimensions, rating the acceptance, practicability, and integration by physiotherapists (PTs) and people with axSpA. Methods A feasibility study was conducted in four pilot exercise therapy groups. PTs performed the assessment battery, consisting of a) the Chester Step Test (CST) for aerobic fitness; b) the modified Core Strength Test for core strength, c) the Bath Ankylosing Spondylitis Metrology Index (BASMI) for spinal mobility and d) the Single Leg Stance Test (SLST) for balance, with the participants of the exercise therapy groups. Subsequently, the PTs and the participants with axSpA rated the acceptance, practicability, and integration by means of questionnaires. Acceptance was operationalised as satisfaction and perceived applicability, practicability was operationalised as feasibility and comprehensibility, and integration was operationalised as usefulness and repeatability. An ordinal scale with four answer options (very good, good, moderate, bad) and a free text field for comments was used. The categories ‘very good’ and ‘good’ were interpreted as ‘positive evaluation’. The feasibility of the assessments was defined based on three levels (I-III): with a positive evaluation of &gt;80% (level I) a specific assessment was considered suitable, with a positive evaluation of 50-80% (level II) adjustments were necessary, with a positive evaluation of &lt;50% (level III) a specific assessment was not considered suitable for group exercise therapy and a new choice had to be made. Results The BASMI was rated level I by people with axSpA and PTs, no adaptations were necessary. The CST was rated level I by people with axSpA and level II by PTs (too time consuming and failure-prone software), resulting in the adaptation that the test can now be performed without software, and a training will make the testing PTs more efficient. The modified Core Strength Test was rated level I by people with axSpA and level II by PTs (instructions unclear), leading to adaptations in the instruction manual. The SLST was rated level I by people with axSpA and level II by PTs (instruction “standing on one leg as long as possible” not useful for persons without balance deficit), leading to the adaptation that the test can be stopped after 60 seconds as the normal values are below that threshold. Conclusion From patient perspective, the feasibility of the tests was evaluated positive in terms of acceptance, practicability and integration (all level I). From PTs’ perspective some adaptations were necessary (level II, except BASMI). After the adaptations, the assessment battery can now be used in group exercise therapy for individuals with axSpA. In this way, the individual fitness status can be evaluated, and interventions can be adapted, and thus the quality of group exercise therapy can be continuously monitored and improved if necessary. Acknowledgements We thank all participants and the SVMB for their support. Disclosure of Interests None declared